- Bob and Brad
the two most famous
physical therapists
on the internet.
- Come on, baby.
Hi folks.
I'm Bob Schrupp, physical therapist
- Brad Heineck, physical therapist.
- And we have the most famous physical therapist
on the internet
- In our opinion, of course Bob.
- Treat with cold heat.
We're gonna talk about when you should, you know
use either one and, and also, you know
for specific problems like trigger points,
muscle injuries sprains,
back, neck, shoulder, knee, ankle, hip pain.
So we're gonna go over kind of some
some of the different circumstances,
and when you should use it when you shouldn't use it.
- Sure. - And also we got some, uh,
product here today, Brad.
- Yeah.
- On display.
- Right. This is nice because
if you go online, you, what do you get?
You know, it all looks the same kind
on the little picture, but
- Yeah.
- They're all a little different.
- We'll let you know how they're, what they're doing.
- Right. We got some, uh, you know, experienced advice.
- So alright, by the way, if you are new
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So please like us.
- Yeah.
- All right.
Let's talk about first, the basics of, of
cold versus heat Brad.
- Sure. - If you have a recent injury
and generally when we say recent injury,
there's usually swelling involved.
- Mmmhmm
- Even if it's your back or your neck, there may
there's still probably swelling that you can't
see going on.
- Sure
- Because you injured it
and that's the body's response.
So after a recent injury, you almost always use ice
- and and recent being, usually 24 to 48 hours.
Pretty much everyone agrees on that
- And you might go longer, um, and especially
the one theme that we're gonna keep kind of
harping on today, is it should feel good.
It should be comfortable, right?
It's not a, a treatment that you're, you know,
no pain no gain type of thing.
- Right.
- So
- exactly. And not only that, but not only while the
the heat or cold is on,
but oftentimes I even say more importantly
to my patients.
How does it feel after you take the hot
or the cold pack off for the next couple
three hours? Does it go right back to where it was
or even worse?
Or does it feel much better as a result of using them
- Excellent poin Brad
By the way, if you're shivering already,
you know, you're cold.
I would not use ice.
I mean, it's not gonna help.
And, and on, on the reverse, if you're,
if you're sweating or inflamed,
you're not gonna put heat on it.
- Right. You know, one guy gave the example
of how his knee was all, you know,
he had hurt his knee and he put heat on it
and it swelled up greatly because of course
it was just recently injured.
- Right, Right So he should have gone the 24 to 48 hours.
I'm gonna go over sometimes
when not to use heat Brad.
If you have an open wound,
diabetes,
you always want to be very careful with that.
Because a lot of times you have
a lack of sensation.
- Oh, sure.
- and you can burn yourself, uh,
or you could get frostbite, um
- Right
When you put a cold pack on,
you want some insulation there
but if you can't feel it, it's another situation
- Dermatitis, inflammation of the skin,
vascular diseases. Again, when you don't
have great circulation you gotta be very careful.
You can not only burn yourself,
but then you can also have a
a sore there that's not gonna heal very easily.
- Right. Right.
- So it's a double trouble DVT, which is a
a blood clot, in your leg.
You don't want to heat that up.
- No
- That's not the way to treat a DVT.
Multiple sclerosis.
They just brought that up because a lot
of times heat can be fatiguing towards you.
- Sure. - It worse make it worse
- Fatigue easily.
- - And of course you don't wanna use heat
if there's increased swelling already.
- Right, right
- I mean, you don't wanna make it worse.
Beware of heat, also,
when you lay on a hot pack or a heating pad
because when you lay on it, the, it
it doesn't disperse the heat as well,
And so you can burn easier.
- Okay.
- And Brad and I were just talking about, I
I had two patients within a week,
just about a month ago,
that had burned themselves.
And you had one too, right?
- Right. Yep.
That was about two months ago.
He put a hot pack on his neck,
fell asleep, and it was electric one.
He had it set on high, fell asleep.
It, it, wasn't the kind of hot pack
that turned off in a certain amount of time.
He got a little scar there, you know?
- Yeah. It'll do it.
So you gotta really be careful with those.
I wouldn't use cold with the same with diabetes
and decreased sensation.
I wouldn't use it if there's a circulation issue.
I wouldn't use it on stiff muscles or joints
and I, and even arthritis.
I, I really generally wouldn't use cold.
- Yeah.
- Unless it feels better to you.
- Right
I have a patient that's very severely arthritic,
and she prefers cold
and it's like,
that's what she wants. She feels better with it.
- Yeah.
- I'm not gonna argue with her.
- And that's the thing. It should feel better.
I think another one to discuss just real briefly
Brad, are trigger points.
A lot of times people think,
they're gonna put, put cold on trigger points.
And a lot of times trigger points are caused
by kind of hypersensitive nerves.
- Mmhmm
- And the cold will probably make it worse.
So more often than not, I I'm my first goal
two thing with trigger points is gonna be heat.
I'm gonna try that.
- Sure.
- So, alright. Let's talk about some of
the products we got here. Brad
These were provided to us by FEI,
don't we have the Cata, yeah. Catalog right here.
If you're a therapist,
fabrication enterprises incorporated.
If you're a therapist, I'd go ahead
and make sure you get this catalog,
- Sure
- because they got some really great deals,
but they sent us a whole array of ice packs here.
Why don't we start off with the ones that can be both.
These could be hot packs and cold packs.
So they're a relief pack.
I'll have these down in the description below.
I think we're gonna make a whole webpage on this Brad
- Sure for, for hot packs of cold packs.
So they come in different sizes.
Yeah. Why don't you show that one, Brad.
- Yeah. So the ones that are made for both
hot and cold, I really like the texture of them.
They conform really well, which is really helpful.
Particularly like this one,
to get something around your neck,
or your shoulder can oftentimes be challenging.
So it stays where it is now.
This, it just wraps around,
and it's kind of a jelly thing.
I've got one of these at,
at one of our clinics, and I really like it
particularly for the shoulder.
Because you can see it wraps over nice.
And it, and it stays right there.
And I like to go back in a recliner
actually with that, you know.
- Like you said for the neck, it
it really works out well for that.
- Yeah.
- Because it, it, it conforms right on.
Now I tried both of these. I mean, I tried it,
I heated it up first in the microwave,
and it tells you how long you should try to
- Sure.
Heat it up in the microwave, depending on how
how powerful your microwave is.
It's not a real intense heat.
It's a, it's a mild heat.
And I also cooled it down,
and it, it, it was a good
it made it cooled down very well.
It serves as a good ice pack.
It's not as cold as a dedicated ice pack one.
That's just for ice alone.
Sure.
- But it's it's believe me, it's plenty
Sure. So yeah, it's, A's a great,
if you know you're thinking
that you don't know which way you're gonna go, heat or ice.
I think this is a great
- Right.
- Alternative.
- You got both, and I just really like
how they conform and the way they feel.
So that's a nice product.
- Yeah. And they're supposed to hold their heat
till I think 20 to 40 minutes, depending
of course on, you know, how long, you know,
you heat it up and I suppose,
what the environment is and such, but
- And that that's called the relief pack
- Relief pack, yeah
Cold and hot
- Yeah
- Is what it's called.
So, so we had three different sizes here.
Right? We had,
Yup.
- We got the, the longer one,
the rectangular shape
the square one would be better
for the back
- Right
- larger areas or the knee.
And, and then this one for the
shoulder or the neck.
- So yeah, again, really cool material.
Now let's say you want to go just with ice alone.
These are some different shapes here too.
Now I've actually written these down.
So I got them, got them down right here.
That's the large,
take the large one out here, Brad.
- Sure. - Is that the large one?
No, that's the large one.
So a pretty good size.
If you're thinking you're you're gonna
go with cold alone.
That's 11 by 21 centimeters.
I don't know what that is in the inches.
- It's that big
- Yeah. It's good for cross the back, you know
or you could wrap it around
if you had a total knee replacement.
- I was just gonna say that, Brad.
- It's really nice
- If you're gonna have a total knee replacement
and, and if you don't think they're gonna
send one along with ya.
- Yep.
- Because the one thing about total
knee replacements, they tend to ice for
a long time. I mean, they,
they go for a couple weeks quite often.
- Yeah. Oh yeah.
And it's nice to go all the way around the knee.
Yeah.
- So, and these, these do get really
intensely cold. You probably sometimes,
even gonna have to put a
a layer of cloth
- Right.
- Between you and especially bony prominence.
- Yeah. I never put cold packs
directly on the skin, always at least one layer
of cloth.
The, you know, I've had patients will use like,
put ice cubes in a Ziploc big,
or just take a cold pack from your cooler,
for your lunch.
- Oh yeah, sure.
And it's just like a hard, like a rock
and they'll use that.
You really need to get something that's gel
- This really makes a difference.
- Big difference.
- I like the material on this too
because if you're a therapist,
and you're using this in a clank,
for infection control purposes.
- Sure. - You can, you can clean these
- Clean up
- Real easily
- Plastic vinyl material, sure.
- Here's another size, Brad.
So this is a,
a little bit, a little bit smaller
- Yup
- More for the shoulder probably.
- Sure.
- And uh, - That would work well there
if you could get around an elbow.
You could use that on a knee or an ankle as well.
- That's 11 by 14
and, and right across the low back,
it's big enough for that.
So it all depends. You know, you may not want to get the
real big one if if you wanna all purpose one,
because this one is probably the most versatile
from all parts of the body where
the big ones sometimes gonna be too big
for the elbow or the ankle
- Sure - Or some of that nature.
- What's that neck one.
Did we talk about that one yet?
- Ah, the neck one.
- So that's the neck one too - Lot of neck.
- You could be upper upper back.
- Yep.
- So,
- But it it's kind of designed to go like that.
- Right.
- And this works pretty good.
It does not conform as well as the hot
and the cold ones, but it's still,
it's a nice, it's a nice pack.
- I just personally would not be thrilled
with putting ice on my neck.
That's just,
- Oh, I don't know Bob, this feels really good.
- Does it feel good?
- I fell on the steps this morning
and my next little sore
- We're experiencing an ice storm here.
So in Minnesota and Wisconsin.
So we're unfortunately having struggle to get in
- Half the schools are closed for all of them.
I don't know.
- But wait yet, we still make it in for you guys.
Okay. Last product here, Brad.
This is called the hot cold donut.
And I've never seen this before.
It's actually pretty cool.
You actually, you can roll it.
I'm gonna take my sleeve up here.
- Oh yeah.
Show that arm, Bob.
- Yeah. So just, it rolls right on.
- This is, this is nice. - Isn't that cool.
- Yeah.
- Now they come in different sizes too.
So you're gonna have to figure out what size you need
because you, it wouldn't roll on to my knee easily.
- Yeah.
- But the next size up would.
- Sure.
- So, and they, they give it comes with a sleeve too.
So you can,
you know, give a little bit
of protection from a getting too cold.
- Yeah. A little barrier
- Yeah
- Yup
- Yeah. This is a, this is really a cool idea.
- Yeah. You said you have a patient right now
you're gonna try it on.
- Yup. He had elbow surgery and
- Oh yeah, that's perfect for that.
- Yeah. I liked it for the, it,
it would actually be good for the ankle, Brad,
for a ankle sprain.
- Sure
Look at this guys.
It just, this is really fun.
It's a good idea.
- But I liked it.
I think it would be really good
for ankle sprains too. Brad. Sure.
It, it wouldn't roll off.
- Do you wanna show it?
I think it's fashionable.
I think you could wear this out
and people would say, cool, look at that.
It's a cool deep blue
- I think you could maybe golf with it.
- Well, yeah.
- Go put it in between rounds when ya.
All right now I just ruined it probably.
- Yeah. Yeah.
Got that.
- Look at that.
- Oh my gosh.
- Yeah. It just go right in place.
- All right - So, now you gotta clean it.
That's a haiku
That cool
That's a Haiku.
All right.
Remember Brad?
- Yeah, we can fix it just about anything
- Except for a broken heart,
- But we're, this might help cool it down.
- Yeah. But we're working on it
- Nice and squishy.
- Thanks for watching.